ImportanceSome young people who identify as transgender and seek gender-affirming medical care subsequently reidentify with their sex registered at birth. Evidence regarding the frequency and characteristics of this experience is lacking.ObjectiveTo determine the frequency of reidentification and explore associated characteristics in a pediatric gender clinic setting.Design, Setting, and ParticipantsThis retrospective cohort study examined all referrals to the Child and Adolescent Health Service Gender Diversity Service at Perth Children’s Hospital between January 1, 2014, and December 31, 2020. The Gender Diversity Service is the sole statewide specialist service in Western Australia that provides children and adolescents up to age 18 years with multidisciplinary assessment, information, support, and gender-affirming medical care. All closed referrals for this study were audited between May 1, 2021, and August 8, 2022.ExposureReidentification with birth-registered sex.Main Outcomes and MeasuresThe number of referrals closed due to reported reidentification with birth-registered sex was determined, as well as descriptives and frequencies of patient demographics (age, birth-registered sex), informant source, International Statistical Classification of Diseases, Tenth Revision gender-related diagnoses, pubertal status, any gender-affirming medical treatment received, and whether subsequent re-referrals were received.ResultsOf 552 closed referrals during the study period, a reason for closure could be determined for 548 patients, including 211 birth-registered males (mean [SD] age, 13.88 [2.00] years) and 337 birth-registered females (mean [SD] age, 15.81 [2.22] years). Patients who reidentified with their birth-registered sex comprised 5.3% (29 of 548; 95% CI, 3.6%-7.5%) of all referral closures. Except for 2 patients, reidentification occurred before or during early stages of assessment (93.1%; 95% CI, 77.2%-99.2%). Two patients who reidentified with their birth-registered sex did so following initiation of puberty suppression or gender-affirming hormone treatment (1.0% of 196 patients who initiated any gender-affirming medical treatment; 95% CI, 0.1%-3.6%).Conclusions and RelevanceThese findings from a pediatric gender clinic audit indicate that a small proportion of patients, and a very small proportion of those who initiated medical gender-affirming treatment, reidentified with their birth-registered sex during the study period. Longitudinal follow-up studies, including qualitative self-report, are required to understand different pathways of gender identity experience.

中文翻译：

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西澳大利亚儿科性别诊所队列中出生登记性别的重新识别

重要性一些自认为跨性别者并寻求性别确认医疗护理的年轻人随后会重新识别出生时登记的性别。缺乏关于这种经历的频率和特征的证据。目的确定重新识别的频率并探索儿科性别诊所环境中的相关特征。设计、环境和参与者这项回顾性队列研究检查了儿童和青少年健康服务性别多样性的所有转诊2014 年 1 月 1 日至 2020 年 12 月 31 日期间在珀斯儿童医院提供服务。性别多样性服务是西澳大利亚州唯一的全州范围内的专家服务，为 18 岁以下的儿童和青少年提供多学科评估、信息、支持和性别平等服务。 - 肯定医疗保健。本研究的所有关闭转诊均在 2021 年 5 月 1 日至 2022 年 8 月 8 日期间进行了审核。暴露与出生登记性别的重新识别。主要结果和措施确定了因报告的出生登记性别重新识别而关闭的转诊数量，以及患者人口统计数据的描述和频率（年龄、出生登记性别）、信息来源、国际疾病统计分类，第十次修订版与性别相关的诊断、青春期状态、接受过的任何性别确认医疗以及是否接受后续转诊。结果在研究期间的 552 例关闭转诊中，可以确定 548 名患者的关闭原因，其中包括 211 名出生登记的患者男性（平均 [SD] 年龄，13.88 [2.00] 岁）和 337 名出生登记女性（平均 [SD] 年龄，15.81 [2.22] 岁）。重新确认出生登记性别的患者占所有转诊关闭的患者的 5.3%（548 例中的 29 例；95% CI，3.6%-7.5%）。除 2 名患者外，重新识别发生在评估之前或评估早期阶段（93.1%；95% CI，77.2%-99.2%）。两名患者在开始青春期抑制或性别肯定激素治疗后重新识别了出生登记的性别（1.0% 开始任何性别肯定药物治疗的 196 名患者；95% CI，0.1%-3.6%）。 结论儿科性别诊所审计的这些结果表明，一小部分患者以及极小部分开始进行性别肯定医学治疗的患者在研究期间重新识别了其出生登记的性别。需要进行纵向随访研究，包括定性自我报告，以了解性别认同体验的不同途径。